Fistula
FISTULA IN ANO (BHAGANDAR) :
About the disease :
Fistula indicates chronic process of Peri-anal abscess which is an acute inflammatory event. It is defined as an abnormal connection between the epithelialised surface of the anal canal and (usually) the peri-anal skin.
Anal fistula originates from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this process is the fistula.
Symptoms & Diagnosis :-
Patients with a fistula -in-ano will recount a history of an abscess that has been drained surgically or drained spontaneously. In addition patients will complain of drainage, bleeding, pain with defecation or decrease in pain with drainage.
Diagnosis is by examination, either in an outpatient setting or under anesthesia (referred to as EUA - Examination under Anaesthesia). The examination can be an anoscopy.
Cause :-
It is a chronic process of an abscess. Anal gland infections and infected fissure-in-ano, are the common causes. It may be secondary to other intestinal diseases.
Investigation :-
Investigation are done to find out the track and the internal opening of the fistula, ultra sound examination using rectal probe, fistulogram, and most reliable being probing with a metal probe.
Treatment :-
There are several stages to treating an anal fistula:
The principle behind the fistula surgery is to eliminate the fistula, prevent recurrence and preserve sphincter function. The treatment being, Fistulotomy, an out-patient procedure done under local anesthesia where the fistula tract is layed open and the fistulous track is frozen to ensure complete destructions.
KSHAR-SUTRA TREATMENT :
This method is most effective non surgical method. This treatment can be done by an Ayurvedic physician. In this method medicated Kshar-sutra is applied through the fistula tract with the help of special probe and it is changed weekly. Within few weeks the fistula tract is cured. Successful rate in this treatment are tremendous. Few surgeons who are aware of this treatment are also suggesting this treatment to the patients.
TREATING ACTIVE INFECTION :
Some patients will have active infection when they present with a fistula, and this requires clearing up before definitive treatment can be decided.
